Monday, April 30, 2012

Goodbye NHS, it was nice knowing you

[NB: I am not the Devil]

I've teasingly had a little play with this at my own pad, but since Sunday's Observer article betrays an astounding lack of collective political antenna on the part of the health establishment, further comment is merited.
A majority of doctors support measures to deny treatment to smokers and the obese, according to a survey that has sparked a row over the NHS's growing use of "lifestyle rationing".

Some 54% of doctors who took part said the NHS should have the right to withhold non-emergency treatment from patients who do not lose weight or stop smoking. Some medics believe unhealthy behaviour can make procedures less likely to work, and that the service is not obliged to devote scarce resources to them.
We all have differing opinions, of course, but one has to wonder what the blithering fuck a majority of these surveyed doctors could possibly have been thinking if—as we are led to believe—they are faithfully wedded to the NHS and its all-inclusive, free at the point of delivery ethos.

There has been an unending stream of 'progressive' commentators in the health service telling us how the NHS Reform Bill is "privatisation by stealth". A perfect example, again at the Guardian domain, being this.
Opponents of privatisation of the NHS would, however, be unwise to focus solely on the issue of hospital management, because the slipperiness of the NHS bill is that it stealthily advances the privatisation of healthcare on several fronts. It does this in primary care, in community health services, and in commissioning – all of it concealed behind the publically trusted NHS logo.
They might want to cast a glance, instead, at the quite idiotic—and dangerously irresponsible—bigots amongst the 54% mentioned above. Again, represented by the NHS logo.

They worry about privatisation by the back door? How about excluding a not inconsiderable section of the population from routine surgery on the premise that—for currently fashionable reasons—they should be denied benefit from their taxes that doctors have been spending for decades on the fucking golf course?

What is expected of a fat bloke who needs a new hip, or a smoker who is denied IVF? They will, of course, go private if they are remotely of substance. The less well-off won't be able to even consider it. Err, that is what one would term a two-tier health service based on ability to pay, and highly anti-progressive at that. Precisely what all the agonising and protests over the NHS Reform Bill have claimed to want to avoid, yet here we have supposedly educated people calling for an advance towards the kind of system they constantly tell us won't work.

The bandwagon is gaining pace on this hilarious destruction of the NHS from within, without any help required from those of us who are quite aware that the whole edifice is constructed on 1940s straw and no longer fit for purpose.

As such, it's astronomically fucking superb that we can sit back and watch as crashingly stupid doctors—the ones who have been lecturing us from their ivory towers for the past decade, remember, about how irrational and misguided we are in choosing our own lifestyles—throw their weight behind the very cloaked privatisation they supposedly fear.
[Dr Clare Gerada, chair of the Royal College of General Practitioners] said: "It's the deserving and undeserving sick idea. The NHS should deliver care according to need. There was no medical justification for such restrictions on smokers, as giving up nicotine would not necessarily enhance an operation's chances of success. Clearly, giving up smoking is a good thing. But blackmailing people by telling them that they have to give up isn't what doctors should be doing."
Nice try, Clare, but your entire profession has been insulting the public and promoting unjustifiable lobbying against behaviours which you don't particularly like for a long time now. Is it any wonder the daft fucktards who you've been brainwashing now stray off-message and get all radical on yo' ass?

Some in the health profession have even gone on record as advocating those who are unable to pay being allowed to die.



It's the kind of hideous inhuman thinking libertarians are ignorantly accused of, yet I've never met a libertarian or classical liberal in my life who ever agreed that should be a possibility under a private system with government-funded vouchers as a safety net for those not able to pay. Only in the ranks of self-described progressive health professionals will you see death and withdrawal of healthcare being touted as a valid policy.

Long live the debate amongst the health profession, in my opinion. In fact, I hope they push the envelope and grip the public's shit big time by moving from obesity and smoking into alcohol use and dangerous sports as a reason to deny healthcare. It won't then be long until someone asks the valid question as to why they have been faithfully paying the state for the NHS via NI contributions if it isn't the presumption of health care which was promised to them from the first time they received a payslip. Just one successful test case and the NHS will be landed with a bill which will make the PPI losses to banks look like chicken feed.

In the appended comments, one Guardian contributor questions whether the 54% are actually insurance salesmen in disguise. Well, why not? They are making a superb case for privatising the NHS and/or potentially moving us into a situation where the NHS will cease to exist due to a financial inability to cover litigious claims.

Oh yeah, and the next time you see your doctor—according to this survey—rather than respect them, you should consider that there is a more than 50% chance that he/she is a myopic, self-absorbed, righteous bell end.


15 comments:

Suboptimal Planet said...

Some in the health profession have even gone on record as advocating those who are unable to pay being allowed to die.

It's the kind of hideous inhuman thinking libertarians are ignorantly accused of, yet I've never met a libertarian or classical liberal in my life who ever agreed that should be a possibility under a private system with government-funded vouchers as a safety net for those not able to pay


Government-funded? You mean taxpayer-funded, i.e. funded by theft.

Call me hideously inhuman, but I think it's perfectly reasonable for a libertarian to expect people to pay their own way in life, and there's no reason healthcare should be treated specially.

What level of healthcare do you feel we are entitled to at everyone else's expense? The very best that 21st century medicine can offer? You mention IVF, but that seems like the height of absurdity to me.

I could accept a voucher system as a transitional measure. It would surely be an improvement on the status quo. But wouldn't we ultimately prefer something voluntary - a combination of private insurance and genuine charity?

If we were to set up an opt-in minarchist state tomorrow, on some unoccupied island, I don't think compulsorily-funded healthcare would feature.

As long as scarce healthcare resources are managed by bureaucrats rather than the free market, there will be nannying and rationing.

I agree with much of what you've written above, but I'm surprised by your apparent support for a generous welfare state. Have I misunderstood your position?

Chris Martin said...

You do realise that there is merit to not performing procedures on overweight people and/or smokers. A new hip might sound nice but it won't hold up a lifetime I calorie accumulation for long enough to make it worthwhile. The fertility programme looks good except when the hormones given add to those your fat pumps out 24/7 for life give you uterine cancer. Health economics is, unsurprisingly, an actual field and it's all cost benefit. Unfortunately if you chose to make choices with the liberty afforded to you that decrease your benefit then you fall under the threshold. Why would it be done for malice or superiority, it's not as if denying procedures frees up time for golf, just means less people turned away in the resource poor system.

Suboptimal Planet said...

"Health economics is, unsurprisingly, an actual field and it's all cost benefit"

Health economics, eh? Mises would be proud. Sounds like just what we need for our socialist commonwealth.

So some bureaucrat guesses at the costs and benefits of a new hip for a smoker with 5 years to live, versus drugs for a non-smoking dementia-sufferer with 10 years to 'live'.

I'd much prefer for people to make their own judgements about quality of life versus quantity of life, and decide for themselves how much to spend on healthcare versus other things. That can only happen if they bear the costs.

Anonymous said...

@Chris Martin:

An artificial hip is never meant to last a life time anyway, most people end up with 2 or more, often not because they are fat but because the material they are made from packs up.

Pregnancy is always dangerous to health, from preeclampsiaand bleeding to death in childbirth to the life-long problems that shredded ladybits cause. So if you want to ban IVF in order to save lives, you're better off demanding mandatory sterilisation for all..

You're in essence saying: People die anyway, so why cure them?

Mr Ecks said...

Lets put it this way--I have paid in for years. Any fucker who says that I am getting nothing becuse of --fill in any reason,who caresabout the reason--is going to have big problems.
My response will be to inform them they will refund the money I have paid in over the decades--a rough calculation is doable--or I will take property from the said GPs premises/NHS hospital--whatever-- to the value of the amount they have stolen from me.

As just one man I would end up fighting with the cops obviously. If I am suffering from something life-threatening it may not matter anyway--I would rather die fighting than expire nastily from some drawn-out untreated ailment.
However, it sounds like this idea would be applied to lots of people--in which case the level of trouble might spoil quite a few medicos golf rounds.

andy5759 said...

I am with Mr Ecks all the way. Deny me treatment because I imbibe more than 21 units of alcohol per week, or because I am a smoker if they dare. My reaction is likely to be violent. I effin mean that!

the a&e charge nurse said...

You are conflating two themes here, illness prevention which might include advice on why smoking might not be a good thing in the long term, and then there is access to health services.

A doctor telling you that some degree of COPD is a near certainty amongst those with a 2 pack habit for 30 years is one thing, denying medical attention for an acute respiratory illness is another.

Rationing IS coming as a result of Lansley's Health & Social care Bill.
But rationing won't be driven by puritanical doctors, but rather by the likes of beardy Branson, or hedge fund managers like Ali Parsa not to mention corporations such as SERCO - any fool can see that the needs of the shareholders will come before clinical excellence.

Simon Jester said...

"You are conflating two themes here, illness prevention which might include advice on why smoking might not be a good thing in the long term, and then there is access to health services."

A&E, you don't appear to have read the article properly - try again:

"Some 54% of doctors who took part said the NHS should have the right to withhold non-emergency treatment from patients who do not lose weight or stop smoking."

the a&e charge nurse said...

There's a difference between rhetoric and reality "Britain is the ONLY country in the industrialised world where wealth does not determine access to healthcare", and provides "the most widely accessible treatments at low cost among rich nations".
http://www.guardian.co.uk/society/2010/nov/18/nhs-best-free-access-healthcare

The NHS can be criticised for many things but comparatively access is not one of them (in terms of populations).

This will change however once beardy and serco have got their feet under the table.

Anonymous said...

"This will change however once beardy and serco have got their feet under the table"

No it won't. The tax payer - for whose benefit the NHS is laughably supposed to exist - will still have the same access as it currently has. We will still have to wait a week to see our GPs and months to get a procedure done because the NHS consultants are busy on the golf course.

What will change is that we will no longer have to fund the retirement plans of public sector workers.

the a&e charge nurse said...

"We will still have to wait a week to see our GPs" - well perhaps people wouldn't have to wait so long if GPs were not expected to provide 250 million consultations each year (or 90% of patient contacts).
http://www.rcgp.org.uk/rcgp_fundraising.aspx

Is there anybody left who doesn't have to see a doctor, and urgently?

shijiefeng said...

http://www.christianlouboutinhomme.com

Medical translator Manchester said...

But isn't there actually some sence in this?

Medical translation service said...

A selfdestructive behaviour must have some consequences.

andy said...

They wont treat me because i`m a smoker and a drinker?Thats OK just give me back the 30 years worth of NI payments that have been taken off me by force.